42 CFR §418.28

1. (a)An individual or representative may revoke the individual's election of hospice care at any time during an election period.
2. (b)To revoke the election of hospice care, the individual or representative must file a statement with the hospice that includes the following information:
   1. (1)A signed statement that the individual or representative revokes the individual's election for Medicare coverage of hospice care for the remainder of that election period.
   2. (2)The date that the revocation is to be effective. (An individual or representative may not designate an effective date earlier than the date that the revocation is made).
3. (c)An individual, upon revocation of the election of Medicare coverage of hospice care for a particular election period—
   1. (1)Is no longer covered under Medicare for hospice care;
   2. (2)Resumes Medicare coverage of the benefits waived under § 418.24(f)(2); and
   3. (3)May at any time elect to receive hospice coverage for any other hospice election periods that he or she is eligible to receive.
4. (d)When the hospice election is ended due to revocation, the hospice must file a notice of termination/revocation of election with its Medicare contractor within 5 calendar days after the effective date of the revocation, unless it has already filed a final claim for that beneficiary.